| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE BENECON GROUP3 | 201 E OREGON ROAD SUITE 100 LITITZ, PA 17543 | SUN LIFE ASSURANCE COMPANY OF CANADA | $6K | $0 | $6K | 20.02% |
| URL INC3 Filed as: URL, INC | 5320 JAYCEE AVE HARRISBURG, PA 17112 | HIGHMARK, INC. | $244 | $0 | $244 | 6.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ETA BENEFITS, INC. BROKER | Insurance agents and brokers Service code 22 | 75 W CATAWISSA STREET NESQUEHONING, PA 18240 | $12K |
| HIGHMARK BC BS NEPA EIN 45-3674900 ADMIN | Claims processing Service code 12 | — | $11K |
| THE BENECON GROUP, LLC EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $8K |
| CONNECTCARE 3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $2K |
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 31 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 31 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED CONCORDIA | 0 | $0 |
| Vision | HIGHMARK, INC. | 31 | $4K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 25 | $31K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 25 | $31K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 25 | $31K |
| Stop-loss / reinsurancereinsurance | EVEREST REINSURANCE COMPANY | 31 | $97K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 25 | $31K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 31 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.